4A (Expenses $ 77664548 including grants of $ 0) (Revenue $ 86372634)
COPLEY HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT IS CRITICAL TO THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

SCHEDULE H, PART V, SECTION B, LINE 5
"COMMUNITY INPUT: THE INFORMATION CONTAINED IN THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT WAS OBTAINED PRIMARILY THROUGH TWO COMMUNITY SURVEYS TAKEN BETWEEN APRIL 9, 2021 AND MAY 20, 2021. OTHER INFORMATION WAS OBTAINED THROUGH REPORTS DEVELOPED BY THE STATE OF VERMONT, THE FEDERAL GOVERNMENT, INDEPENDENT RE- SEARCH ORGANIZATIONS, AND LOCAL NONPROFIT AGENCIES SERVING PEOPLE WITHIN OUR SERVICE AREA. BECAUSE OF THE COVID-19 PANDEMIC, TRADITIONAL FACE-TO-FACE AND IN-PERSON INFORMATION GATHERING AVENUES AND TECHNIQUES WERE NOT AVAILABLE TO US. COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEYS WERE OPEN FOR RESPONSES BETWEEN APRIL 9 AND MAY 20, 2021 THROUGH ""SURVEY MONKEY"" AS WELL AS VIA PRINTED COPIES MADE AVAILABLE AT THE HOSPITAL AND SATELLITE OFFICES. THE LINK TO THE SURVEY MONKEY SURVEYS WAS DISTRIBUTED VIA EMAIL TO COPLEY HOSPITAL TRUSTEES, COMMITTEE MEMBERS AND AMBASSADORS, MEDICAL PROVIDERS, AND DIRECTLY TO MEMBERS OF THE COMMUNITY. IT WAS ALSO AVAILABLE ON OUR FACEBOOK PAGE AND ON FRONT PORCH FORUM, A COMMUNITY BULLETIN BOARD FREQUENTED BY NUMEROUS PEOPLE WITHIN OUR SERVICE AREA. HUNDREDS OF SURVEYS WERE SENT OUT AND THE LINK WAS AVAILABLE TO THOUSANDS OF RESIDENTS, HOWEVER THE RESPONSE RATE WAS LIGHT, WITH ONLY 159 PEOPLE RESPONDING. OF THOSE RESPONDING, 34% WERE BETWEEN THE AGES OF 54-65, AND 30% WERE BETWEEN THE AGES OF 44-55. ONLY FIVE PERCENT OF RESPONSES WERE AGE 65 OR OLDER."

SCHEDULE H, PART V, SECTION B, LINE 7A
CHNA URL: HTTPS://WWW.COPLEYVT.ORG/ABOUT-US/NEWSLETTER/

SCHEDULE H, PART V, SECTION B, LINE 10A
IMPLEMENTATION STRATEGY URL: HTTPS://WWW.COPLEYVT.ORG/ABOUT-US/NEWSLETTER/

SCHEDULE H, PART V, SECTION B, LINE 11
"ADDRESSING IDENTIFIED NEEDS: HEALTHCARE NEED #1: MENTAL HEALTH AS IN THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT, MENTAL HEALTH ISSUES WERE IDENTIFIED BY SURVEY RESPONDENTS AS ONE OF OUR SERVICE AREA'S MOST PRESSING CONCERNS. MENTAL HEALTH ISSUES INCLUDE DEPRESSION AND OTHER ILLNESSES LEADING TO SELF-HARM AND/OR TO SUICIDE. AS OF 2019, THE RATE OF SUICIDE DEATHS IN VERMONT WAS 16 PER 100,000 PEOPLE - UP FROM 15.3 IN 2015. THE STATE RATE OF SUICIDE DEATHS IS 13.9. THE HEALTHY VERMONTERS 2020 TARGET IS 11.7 DEATHS PER 100,000.* AMONG VERMONT ADULTS WHO REPORTED SYMPTOMS OF ANXIETY AND/OR DEPRESSIVE DISORDER, 24.2% REPORTED NEEDING, BUT NOT RECEIVING, COUNSELING OR THERAPY (SOURCE: KAISER FAMILY FOUNDATION APRIL 2021). AC- CORDING TO KAISER, THE STATES WITH THE HIGHEST PERCENTAGE OF ADULTS REPORTING SYMPTOMS OF ANXIETY AND/OR DEPRESSIVE DISORDER BUT NOT RECEIVING CARE ARE VERMONT (38.8%), SOUTH DAKOTA (35.9%), IDAHO (32.5%), CONNECTICUT (31.9%), AND LOUISIANA (31.6%). SUICIDE IS ONE OF THE LEADING CAUSES OF DEATH IN THE U.S. AND HAS INCREASED IN ALMOST EVERY STATE OVER TIME, MAKING IT A SERIOUS PUBLIC HEALTH CONCERN. WHILE SUICIDE IS OFTEN LINKED TO UNDERLYING MENTAL HEALTH CONDITIONS, OTHER FACTORS CAN ALSO CONTRIBUTE, INCLUDING ISOLATION, RELATIONSHIP STRUGGLES, FINANCIAL OR HOUSING INSECURITY, OR PROBLEMS WITH PHYSICAL HEALTH. MANY OF THESE CONDITIONS WERE EXACERBATED ACROSS THE COUNTRY AS WELL AS HERE IN VERMONT DURING THE 2020-21 COVID PANDEMIC. ACCORDING TO THE KAISER FAMILY FOUNDATION (2021): . 22.4 PERCENT OF VERMONTERS REPORT BEING DEPRESSED (2020); 14% REPORTED FREQUENT MENTAL DISTRESS. . IN VERMONT, 51.0% OF ADULTS WITH MILD MENTAL ILLNESS; 44.3% OF ADULTS WITH MODERATE MENTAL ILLNESS; AND 25.6% OF ADULTS WITH SERIOUS MENTAL ILLNESS IN THE PAST YEAR DID NOT RECEIVE MENTAL HEALTH TREATMENT. WHEN PATIENTS COME TO COPLEY'S EMERGENCY DEPARTMENT (ED), 85% ARE SCREENED FOR SUICIDALITY USING THE COLUMBIA SUICIDE SEVERITY RATING SCALE.*. (NOT ALL ER PATIENTS REQUIRE THIS KIND OF SCREENING). PATIENTS ARE ALSO ASKED ABOUT THEIR HOUSING SITUATION WHEN THEY VISIT THE ED (E.G. DO THEY LIVE WITH OTHERS? DO THEY LIVE ALONE?). THEY ARE NOT SCREENED FOR HOUSING OR FOOD INSECURITY UNLESS THEY ARE REFERRED TO THE COMMUNITY REFERRAL SPECIALIST FOR AN IDENTIFIED NEED. THE SPECIALIST THEN SCREENS THEM FOR THOSE SOCIAL DETERMINANTS. WHEN MENTAL HEALTH ISSUES PRESENT, PATIENTS ARE REFERRED TO THE MOBILE CRISIS TEAM AND/OR TO OUTPATIENT MENTAL HEALTH SERVICES. COPLEY HAS ENGAGED A FULL TIME DAY EMERGENCY ROOM CARE COORDINATOR/SOCIAL WORKER WHO IS EMBEDDED INTO THE ED AND WHO SERVES AS A LIAISON WITH OUR COMMUNITY PARTNERS. APPROXIMATELY 100 REFERRALS TO VARIOUS CARE PROVIDERS ARE MADE EACH MONTH. COPLEY HOSPITAL DOES NOT YET HAVE, BUT WOULD BENEFIT FROM ENGAGING, AN EVENING ED CARE COORDINATOR, AS A NUMBER OF WORKING INDIVIDUALS/ FAMILIES COME TO THE ED IN THE EVENING. WORTH NOTING: DURING THE COVID PANDEMIC, COPLEY HAS NOT SEEN AS MANY MENTAL HEALTH PATIENTS AS IT DOES IN A TYPICAL YEAR. WHILE THE TRENDS (PRIOR TO COVID) INDICATED A RISE IN SUICIDE AND MENTAL HEALTH OCCURRENCES IN THE WINTER MONTHS, COPLEY CURRENTLY CONTINUES TO SEE MORE PATIENTS WITH THESE SYMPTOMS IN THE SUMMER MONTHS. PATIENTS WHO DO PRESENT AT OUR ED AND UNDERGO SCREENING ARE OFTEN REFERRED TO A COMMUNITY REFERRAL SPECIALIST WHO CONNECTS THEM TO OTHER INDIVIDUALS AND SERVICES THAT CAN HELP THEM ADDRESS THE ISSUES WITH WHICH THEY ARE STRUGGLING. IN MANY CASES, THESE PATIENTS ARE UNAWARE OF THE SERVICES THAT ARE AVAILABLE TO THEM. DESPITE THE COVID-19 PANDEMIC, A TOTAL OF 1,222 REFERRALS WERE MADE TO THE COMMUNITY REFERRAL SPECIALIST BETWEEN MAY OF 2019 AND MAY OF 2020 AND ACCORDING TO THE COMMUNITY REFERRAL SPECIALIST, 1,369 REFERRALS WERE MADE BETWEEN MAY 1, 2020 - APRIL 30, 2021. THE REASONS FOR THE REFERRAL INCLUDED CONNECTING PATIENTS TO A PRIMARY CARE PRACTITIONER, FINDING A MENTAL HEALTH COUNSELOR, FINDING A DENTIST, HOUSING INSECURITY, LACK OF TRANSPORTATION, FOOD INSECURITY, DOMESTIC VIOLENCE, CHILD ENDANGERMENT, AND OTHER SUPPORT SERVICES. HEALTHCARE NEEDS # 2 AND 4: OBESITY / POOR EATING HABITS OBESITY AND POOR EATING HABITS TOOK THE NUMBER TWO AND FOUR SPOTS IN OUR 2021 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY, INDICATING A FAIRLY HIGH LEVEL OF CONCERN AMONG PEOPLE IN OUR SERVICE AREA ABOUT THE GROWING PROBLEM OF POOR NUTRITION AND FOOD INSECURITY. ACCORDING TO AMERICA'S HEALTH RANKINGS (2020), 26.6% OF VERMONTERS ARE CLINICALLY DEFINED AS ""OBESE."" ACCORDING TO THE NATIONAL CENTERS FOR DISEASE CONTROL AND PREVENTION: . 55% OF VERMONT ADULTS ARE OVERWEIGHT OR OBESE. . 26% OF VERMONT HIGH-SCHOOL STUDENTS ARE OVERWEIGHT OR AT RISK OF BECOMING OVERWEIGHT . 30% OF LOW-INCOME CHILDREN BETWEEN 2 AND 5 YEARS OF AGE IN VERMONT ARE OVERWEIGHT OR AT RISK OF BECOMING OVERWEIGHT. IN VERMONT, 14% OF YOUTH BETWEEN THE AGES 10 TO 17 HAVE OBESITY, GIVING VERMONT A RANKING OF 28 AMONG THE 50 STATES AND D.C.; AND THE HIGHEST RANKING (1) AMONG THE SIX NEW ENGLAND STATES. (SOURCE: ROBERT WOOD JOHNSON FOUNDATION, 2020) OBESITY INCREASES THE RISK OF MANY SERIOUS DISEASES AND HEALTH CONDITIONS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, TYPE 2 DIABETES, CORONARY ARTERY DISEASE, STROKE, GALLBLADDER DISEASE, AND SOME CANCERS. FOOD INSECURITY FOOD INSECURITY IS NOT ONLY A LEADING CAUSE OF OBESITY AND POOR NUTRITION, BUT ALSO DENTAL ISSUES. GOOD FOOD IS EXPENSIVE. INEXPENSIVE FOOD IS GENERALLY HIGH SODIUM AND FAT. THERE ARE SEVERAL PROGRAMS SUCH AS SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) THAT ENCOURAGE THE PURCHASE AND CONSUMPTION OF HEALTHY FOODS, AND MOST SNAP BENEFITS ARE NOW ACCEPTED AT LOCAL FARMERS' MARKETS. THROUGH REFERRALS TO THE RECOVERY CENTER AND THE COMMUNITY REFERRAL SPECIALIST, COPLEY PUTS PATIENTS IN TOUCH WITH THESE PROGRAMS. COPLEY ALSO PARTICIPATED IN VT EVERYONE EATS! VT EVERYONE EATS! (VEE) PROVIDES NUTRITIOUS MEALS TO VERMONTERS IN NEED OF FOOD ASSISTANCE, AS WELL AS A STABILIZING SOURCE OF INCOME FOR VERMONT RESTAURANTS, FARMERS, AND FOOD PRODUCERS. FUNDED BY THE VERMONT LEGISLATURE TO ADDRESS COVID IMPACTS, VEE IS ADMINISTERED BY SOUTHEASTERN VERMONT COMMUNITY ACTION, SEVCA. FINALLY, THE VT FOODBANK'S VEGGIE VAN GO PROGRAM MAKES DELIVERIES OF FRESH FOOD AND PRODUCE TO SCHOOLS AND HOSPITALS ACROSS VERMONT. COPLEY IS CURRENTLY EXPLORING A COLLABORATION WITH THIS PROGRAM. HEALTHCARE NEED #3: SUBSTANCE ABUSE SUBSTANCE ABUSE WAS IDENTIFIED AS OUR COMMUNITY'S THIRD MOST CHALLENGING HEALTH CONCERN IN 2021, MOV- ING UP A NOTCH FROM NUMBER FOUR IN 2018. ACCORDING TO MOST EXPERTS, IT IS A PROBLEM THAT CONTINUES TO IMPACT COMMUNITIES ACROSS THE UNITED STATES. SUBSTANCE ABUSE IS DEFINED AS ""A MALADAPTIVE PATTERN OF SUBSTANCE USE LEADING TO CLINICALLY SIGNIFICANT IMPAIRMENT OR DISTRESS, AS MANIFESTED BY ONE (OR MORE) OF THE FOLLOWING, OCCURRING WITHIN A 12-MONTH PERIOD:""* . RECURRENT SUBSTANCE USE RESULTING IN A FAILURE TO FULFILL MAJOR ROLE OBLIGATIONS AT WORK, SCHOOL, OR HOME (E.G., REPEATED ABSENCES OR POOR WORK PERFORMANCE RELATED TO SUBSTANCE USE; SUBSTANCE-RE- LATED ABSENCES, SUSPENSIONS, OR EXPULSIONS FROM SCHOOL; NEGLECT OF CHILDREN OR HOUSEHOLD). . RECURRENT SUBSTANCE USE IN SITUATIONS IN WHICH IT IS PHYSICALLY HAZARDOUS (E.G., DRIVING AN AUTOMOBILE OR OPERATING MACHINERY WHEN IMPAIRED BY SUBSTANCE ABUSE). . RECURRENT SUBSTANCE-RELATED LEGAL PROBLEMS (E.G., ARRESTS FOR SUBSTANCE-RELATED DISORDERLY CONDUCT). . CONTINUED SUBSTANCE USE DESPITE HAVING PERSISTENT OR RECURRENT SOCIAL OR INTERPERSONAL PROBLEMS CAUSED OR EXACERBATED BY THE EFFECTS OF THE SUBSTANCE (E.G., ARGUMENTS WITH SPOUSE ABOUT CONSEQUENCES OF INTOXICATION, PHYSICAL FIGHTS). . DRUG OVERDOSE DEATHS INVOLVING OPIOIDS TOTALED 127 IN 2018 (A RATE OF 22.8 PER 100,000 STANDARD POPULATION) AND HAVE REMAINED STEADY SINCE 2016. . DEATHS INVOLVING SYNTHETIC OPIOIDS OTHER THAN METHADONE (MAINLY FENTANYL AND FENTANYL ANALOGS) HAVE TRENDED UP FROM 33 (A RATE OF 5.6) IN 2015 TO 106 (A RATE OF 19.3) IN 2018 . HEROIN-INVOLVED DEATHS ARE ALSO RISING WITH 68 DEATHS (A RATE OF 12.5) IN 2018. . PRESCRIPTION OPIOIDS HAVE REMAINED STEADY WITH 27 DEATHS (A RATE OF 4.4) IN 2018. AS WELL, ACCORDING TO THE VERMONT DEPARTMENT OF HEALTH: . MARIJUANA USE AMONG YOUTH AND ADULTS IS INCREASING. . VAPING USE AMONG HIGH SCHOOL STUDENTS INCREASED EIGHT-FOLD BETWEEN 2017 AND 2019. . AMONG HIGH SCHOOL STUDENTS, PEER AND PERCEIVED PARENTAL DISAPPROVAL OF MARIJUANA USE HAVE DE- CREASED OVER THE PAST DECADE. . OVER THE PAST FIVE YEARS, TWO-THIRDS OF OPERATORS INVOLVED IN FATAL CRASHES SUSPECTED OF DRIVING UNDER THE INFLUENCE OF DRUGS HAD THC IN THEIR SYSTEMS. RECOVERY SERVICES TO ADDRESS THIS GROWING PROBLEM, PATIENTS WHO PRESENT AT OUR ED HAVE A NUMBER OF SERVICES AND PROGRAMS AVAILABLE TO THEM, INCLUDING REFERRALS TO A RECOVERY COACH THROUGH THE NORTH CENTRAL VERMONT RECOVERY CENTER (NCVRC). A RECOVERY COACH HELPS PATIENTS CREATE A PERSONAL PLAN FOR RECOVERY BY SETTING REALISTIC GOALS (OFTEN WITH THE ASSISTANCE OF A ""PEER"" WHO HAS BEEN"

SCHEDULE H, PART V, SECTION B, LINES 16A-C
FAP, APPLICATION, AND PLS URL: WWW.COPLEYVT.ORG/FOR-PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/

SCHEDULE H, PART I, LINE 3C:
ELIGIBILITY FOR FREE CARE: IN ADDITION TO INCOME, COPLEY USES OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE, INCLUDING RESIDENCY STATUS FOR NON-EMERGENT SERVICES AND AN ASSET THRESHOLD.

SCHEDULE H, PART I, LINE 7:
COSTING METHODOLOGY: THE COST TO CHARGE RATIO COMPUTED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION ON IRS WORKSHEETS 1 AND 3.

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2021. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: COPLEY HOSPITAL, INC ESTIMATES THAT APPROXIMATELY 9.1% OF THE PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR CHARITY CARE OR OTHER ASSISTANCE BUT CHOSE NOT TO APPLY. THEREFORE, THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING 9.1% OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 4
"BAD DEBT EXPENSE FOOTNOTE: THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE AND PATIENT ACCOUNTS RECEIVABLE IS FOUND ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, SUBTITLED ""PATIENT ACCOUNTS RECEIVABLE."""

SCHEDULE H, PART III, SECTION B, LINE 8
COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION POLICY: FINANCIAL ASSISTANCE IS AVAILABLE TO GUARANTORS WHO MEET THE ELIGIBILITY REQUIREMENTS. INCOME LEVEL, HOUSEHOLD SIZE, RESIDENCY STATUS, ETC, DETERMINE ELIGIBILITY. FEDERAL POVERTY LEVEL GUIDELINES ARE UTILIZED TO DETERMINE THE AMOUNT OF ASSISTANCE A HOUSEHOLD MAY BE ELIGIBLE FOR. FOR THE PATIENT'S CONVENIENCE, ALL STATEMENTS HAVE AN ABBREVIATED VERSION OF THE FINANCIAL ASSISTANCE APPLICATION ON THE BACK.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: COPLEY GATHERS AND ANALYZES INFORMATION ABOUT THE GREATER LAMOILLE VALLEY COMMUNITY AND ITS HEALTHCARE NEEDS THROUGH VARIOUS MEANS, INCLUDING: ANALYZING AND RESPONDING TO HEALTH TRENDS IN OUR PATIENTS; THROUGH AGGREGATE DATA FROM OUR QUALITY AND WELLNESS INITIATIVES, THE ONECARE VERMONT ACCOUNTABLE CARE ORGANIZATION, THE VERMONT STATE BLUEPRINT FOR HEALTH AND FROM THE UNIFIED COMMUNITY COLLABORATIVE (UCC) WHICH INCLUDES REPRESENTATIVES FROM COMMUNITY, REGIONAL AND STATE ORGANIZATIONS AND AGENCIES INVOLVED IN THE SOCIAL DETERMINANTS OF HEALTH. WE ALSO REVIEW RELEVANT DATA FROM THE VERMONT DEPARTMENT OF HEALTH, CENTERS FOR MEDICARE AND MEDICAID SERVICES, AND THE FEDERAL CENTERS FOR DISEASE CONTROL.

SCHEDULE H, PART VI, LINE 3
"PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: INFORMATION ABOUT COPLEY'S CHARITABLE CARE POLICY, WHICH INCLUDES HELPING PATIENTS APPLY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS, IS POSTED BY EACH REGISTRATION DESK (MAIN LOBBY AND EMERGENCY DEPARTMENT). IT IS ALSO AVAILABLE, ALONG WITH THE APPLICATION FORM, ONLINE ON THE HOSPITAL'S WEBSITE IN ADDITION TO THE ""HOSPITAL REPORT CARD"" WEBSITE OF THE GREEN MOUNTAIN CARE BOARD. DETAILS ARE ALSO INCLUDED IN THE PATIENT GUIDE FOR INPATIENTS, FAMILIES AND VISITORS. COPLEY'S CHARITABLE CARE PROGRAM IS ALSO PROMOTED IN OUR PHILANTHROPY EFFORTS AS MANY DONORS GIVE TO THE PROGRAM. ALL CARE PROVIDERS MAY REFER PATIENTS TO THE HOSPITAL'S PATIENT FINANCIAL SERVICES COUNSELORS OR TO PATIENT AND FAMILY SERVICES TO CONNECT THEM TO ASSISTANCE."

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: COPLEY HOSPITAL, DEFINES ITS SERVICE AREA AS LAMOILLE, AND PARTS OF ORLEANS AND CALEDONIA COUNTIES IN VERMONT, WHICH INCLUDES THE TOWNS OF BELVEDIRE, CAMBRIDGE, JEFFERSONVILLE, WATERVILLE, EDEN, EDEN MILLS, HYDE PARK, JOHNSON, ELMORE, MORRISTOWN, MOSCOW, NORTH HYDE PARK, STOWE, WOLCOTT, CRAFTSBURY, GREENSBORO, HARDWICK AND STANNARD. COPLEY SERVES A POPULATION OF 30,387 PEOPLE. LAMOILLE COUNTY IS ONE OF THE FEW COUNTIES SEEING POPULATION GROWN IN VERMONT, WITH AN ESTIMATED POPULATION OF 30,849 BY 2022. THE COMMUNITY IS PREDOMINANTLY WHITE, NON-HISPANIC, WITH A MEDIAN AGE OF 40.9 AND A MEDIAN HOUSEHOLD INCOME OF $64,003. THE AREA HAS POCKETS OF GREAT WEALTH AND GREAT POVERTY. THE TOP THREE PRIORITY POPULATIONS ARE RESIDENTS OF RURAL AREAS, LOW-INCOME GROUPS, AND CHILDREN. NEARLY 15.53% OF THE HOSPITAL'S SERVICE AREA IS GREATER THAN 65 YEARS OF AGE. NEARLY 93% OF ADULTS 25 YEARS OF AGE OR OLDER IN THE AREA HOLD A HIGH SCHOOL DEGREE, 38% HOLDING A BACHELOR'S DEGREE OR HIGHER. THE MAJOR INDUSTRY IS ACCOMMODATIONS AND FOOD SERVICE, FOLLOWED BY HEALTH AND SOCIAL ASSISTANCE. THE LEADING CAUSES OF DEATH ARE FROM CANCER, HEART DISEASE, AND LUNG DISEASE. ADVERSE METRICS IMPACTING MORE THAN 30% OF THE POPULATION AND STATISTICALLY SIGNIFICANTLY DIFFERENT FROM THE NATIONAL AVERAGE INCLUDE: - BMI IN MORBID/OBESE RANGE AT 10% ABOVE AVERAGE, IMPACTING 33.7% - ROUTINE CHOLESTEROL SCREENING = 9.8% BELOW AVERAGE, IMPACTING 40.0% - CANCER SCREEN: PAP/CERV TEST 2 YR = 9.1% BELOW AVERAGE, IMPACTING 43.8% - OB/GYN 1+ VISIT = 11.5% BELOW AVERAGE, IMPACTING 34.0%. BENEFICIAL METRICS IMPACTING MORE THAN 30% OF THE POPULATION AND STATISTICALLY SIGNIFICANTLY DIFFERENT FROM THE NATIONAL AVERAGE INCLUDE: - CONSUMED ALCOHOL IN THE PAST 30 DAYS = 18.3% BELOW AVERAGE, IMPACTING 43.9% - NP/PA VISIT IN THE LAST 6 MONTHS = 10.7% ABOVE AVERAGE, IMPACTING 45.9% RECENT STUDIES INDICATE LAMOILLE COUNTY HAS THE HIGHEST RATE OF SUICIDE IN THE STATE.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: THE HOSPITAL IS GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES MADE UP OF LOCAL CITIZENS REPRESENTING A CROSS SECTION OF THE COMMUNITY SERVED. THE BOARD HOLDS A PUBLIC ANNUAL MEETING IN JANUARY AND ITS ETHICS COMMITTEE HOSTS AN ANNUAL PUBLIC FORUM ON A TOPIC PERTINENT TO POPULATION HEALTH. COPLEY CONTINUES TO WORK COLLABORATIVELY WITH OTHER ORGANIZATIONS TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS. OUR COLLABORATIONS INCLUDE BUT ARE NOT LIMITED TO THE UNIFIED COMMUNITY COLLABORATIVE (UCC) WHICH INCLUDES REPRESENTATIVES FROM COMMUNITY, REGIONAL AND STATE ORGANIZATIONS AND AGENCIES INVOLVED IN THE SOCIAL DETERMINANTS OF HEALTH; PRIMARY CARE PRACTICES; LAMOILLE HORNE HEALTH AND HOSPICE; LONG-TERM RESIDENTIAL CARE FACILITIES THE MANOR AND THE GREENSBORO NURSING HORNE; LAMOILLE COUNTY MENTAL HEALTH; COMMUNITY HEALTH SERVICES OF LAMOILLE VALLEY BEHAVIORAL HEALTH & WELLNESS; HEALTHY LAMOILLE VALLEY; PEOPLE IN PARTNERSHIP; THE MORRISVILLE DISTRICT OFFICE OF THE VERMONT DEPARTMENT OF HEALTH; THE LAMOILLE COMMUNITY HOUSE (WARMING SHELTER); UNITED WAY; CLARINA HOWARD NICHOLS CENTER; THE NORTH CENTRAL VERMONT RECOVERY CENTER; AND OTHERS. COPLEY HOSPITAL PROVIDES NEEDED MEDICAL SERVICES, REGARDLESS OF ABILITY TO PAY. SERVICES INCLUDES 24 HOURS/7 DAYS A WEEK EMERGENCY SERVICES, WOMEN'S AND CHILDREN'S SERVICES, GENERAL SURGERY, LABORATORY SERVICES, DIAGNOSTIC IMAGING, ORTHOPAEDICS, AND REHABILITATION. COPLEY CONTINUES ITS PARTNERSHIP WITH DARTMOUTH HITCHCOCK CONNECTED CARE TO DELIVER NEEDED SERVICES IN THE AREA WITH TELEMEDICINE; INCLUDING RHEUMATOLOGY, NEPHROLOGY AND PULMONOLOGY. IN CONJUNCTION WITH COMMUNITY HEALTH SERVICES OF LAMOILLE VALLEY, COPLEY HAS PLACED A RESOURCE REFERRAL SPECIALIST IN THE ER. THIS SPECIALIST WORKS CLOSELY WITH OUR SOCIAL WORKER AND OUR UTILIZATION REVIEW NURSE TO SCREEN AND CONNECT PATIENTS TO NEEDED SERVICES AND COMMUNITY RESOURCES TO ADDRESS A VARIETY OF ISSUES INCLUDING QUIT SMOKING, FUEL INSECURITY, FOOD INSECURITY, HOMELESSNESS OR INADEQUATE HOUSING, SUBSTANCE ABUSE, MENTAL HEALTH AND/OR LONG TERM MANAGEMENT OF COMPLEX CONDITIONS. AN ONGOING INITIATIVE FOCUSES ON IDENTIFYING PATIENTS WITH COMPLEX HEALTH ISSUES THAT ARE HIGH UTILIZERS OF EMERGENCY SERVICES AND CONNECTING THEM WITH A DEDICATED CASE WORKER TO DEVELOP A COORDINATED CARE PLAN. THIS EFFORT HAS RESULTED IN A SIGNIFICANT REDUCTION IN AVOIDABLE USE OF THE EMERGENCY ROOM, CREATING A POTENTIAL - SAVINGS FOR THE AREA'S HEALTHCARE SYSTEM. TO HELP ADDRESS HOMELESSNESS IN THE AREA, COPLEY PROVIDES LAUNDRY SERVICES TO A GRASSROOTS WARMING SHELTER THAT OPENED IN THE AREA. ALL OF THESE EFFORTS IMPROVE TRANSITIONS IN CARE AND OUTCOMES, WITH THE GOAL BEING THE IMPROVEMENT OF THE HEALTH OF OUR COMMUNITY. AS ONE OF THE LARGEST EMPLOYERS IN THE AREA, THE HOSPITAL IS INVESTING IN EDUCATION AND TRAINING IN SUPPORT OF RECRUITMENT AND RETENTION. COPLEY PARTNERS WITH VERMONT TECHNICAL COLLEGE, NORTHERN VERMONT UNIVERSITY & LAMOILLE'S WORKFORCE DEVELOPMENT GROUP TO OFFER AN ASSOCIATE DEGREE IN NURSING PROGRAM HERE IN LAMOILLE COUNTY. THE HOSPITAL WORKS WITH MANY EDUCATIONAL INSTITUTIONS, OFFERING ONSITE CLINICAL ROTATIONS ALONG WITH 8 GRADUATE PROGRAMS IN NURSING, MEDICINE AND HEALTHCARE ADMINISTRATION. THE HOSPITAL CONTINUES TO BE A KEY PARTNER IN THE LAMOILLE COUNTY CHAPTER OF RISE VERMONT, A STATE-WIDE INITIATIVE WITH THE STATE'S ACCOUNTABLE CARE ORGANIZATION. RISEVT SUPPORTS AND INSPIRES RESIDENTS TO HAVE FUN, PLAY MORE, EAT WELL AND FEEL GOOD BY AMPLIFYING AND SUPPORTING EFFORTS UNDERWAY IN THE COMMUNITY. THE RISEVT PROGRAM MANAGER IS EMPLOYED BY THE HOSPITAL. RISEVT OPERATED WELLNESS PROGRAMMING IN THE TOWNS OF MORRISVILLE AND JOHNSON, AND ATTENDS MULTIPLE HEALTH AND WELLNESS EVENTS ACROSS OUR SERVICE AREA THROUGHOUT THE YEAR. THE HOSPITAL REGULARLY PROMOTES HEALTHY LIFESTYLE CHOICES AND PREVENTATIVE INFORMATION VIA SOCIAL MEDIA OUTLETS, INCLUDING AN AWARD-WINNING COLLABORATIVE COMMUNITY BLOG (LIVEWELLLAMOILLE.COM), COMMUNITY NEWSLETTERS, INFORMATION DISTRIBUTED ON THE HOSPITAL CAMPUS, AND A YEAR-LONG SERIES OF INFORMATIONAL SEMINARS THAT COVER A RANGE OF TIMELY HEALTH AND WELLNESS TOPICS. WE PROMOTE AND SUPPORT HEALTHY, FAMILY-FRIENDLY ACTIVITIES AND EVENTS TO ENCOURAGE HEALTHY LIFESTYLE CHOICES.